An integrated, multidisciplinary research program is proposed which has as a general goal the identification and control of acute, intercurrent processes which may influence growth and development of the respiratory system with resultant long-term sequelae. Longitudinal studies of infants and children will establish normal patterns of growth of lung function and the impact on this of acute respiratory infection with emphasis on the syndrome of bronchiolitis. High-risk newborn infants will be followed similarly to assess the injury to immature lungs produced by the respitatory distress syndrome, differentiating infectious and idiopathic causes. These prospective clinical studies would be complemented by retrospective approaches of three types: 1) comprehensive evaluations of patients referred for recurrent or chronic pogressive pulmonary diseases (including those with cyctic fibrosis, sarcoidosis and anti-protease or immune deficiencies) to identify responsible defects in pulmonary defense mechanisms: 2) follow-up studies of children in the community documented to have had infections during the past decade with agents such as respiratory syncytial virus; and 3) assessment of the burden of pulmonary disability among North Carolina children by development, testing and validation of pediatric questionnaires to facilitate case finding and early diagnosis. Relevant basic laboratory studies would be performed using experimental models of respiratory diseases (animals and cultures of specialized pulmonary cells infected with representative agents) to define the mechanisms of injury, repair and protection. This combination of clinical and basic research should lead to improved means of diagnosis, therapy and prevention of respiratory diseases and their complications or sequelae.